Hardister

cant Name
ess 3 Z 2.
CERTIFICATION OF EXEMPTION
FROM REQUIRING A CAMA PERMIT
as authorized by the State of North Carolina,
Department of Environment, Health, and Natural Resources and the Coastal Resources Commission
in an area of environmental concern pursuant to 15 NCAC Subchapter 7K .0203.
i P2
!ct U*ffiiorf (County, State Road, Water Body, etc.)
State _
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Phone Number 9 - 4
Zip
and Dimensions of Project ,7N s . A L /U JD�,9c%o.� o 7. -e -,Agt,,�' r c -,e IS 4- .
roposed project to be located and constructed as described
is hereby certified as exempt from the CAMA permit re-
nent pursuant to 15 NCAC 7K .0203. This exemption to
% permit requirements does not alleviate the necessity of
)btaining any other State, Federal, or Local authorization.
This certification of exemption from requiring a CAMA per
valid for 90 days from the date of issuance. Following expiry
a re-examination of the project and project site may be nece!
to continue this certification.
(SCALE: all '

X7-26-2010 15153 From:OCM MFDCTY To:31910S42T4T1 Page:212
10/2812010 16:24 FAX [phone]? FHC MaH SVLtchboard Svcs 110011001
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Data
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Khme of Property Owaar Applying for Permit.
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behalf, for the pt:rpose of apploog for and obtaining all CAM Pere lt. nooavary to
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at (MY Pre"My boated at) J39 1
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